Clavipectoral fascial plane block combined with superficial cervical plexus block has been used as an anesthetic and analgesic technique in mid-clavicle fracture surgeries. The authors describe two cases in which patients underwent extraction of osteosynthesis material from the clavicle, using clavipectoral fascial plane block combined with superficial cervical plexus block as an anesthetic and analgesic technique in the postoperative period. The mentioned block presented itself as an easy-to-perform technique, apparently safe and effective, allowing to obtain satisfactory results.

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Background: Malignant Hyperthermia (MH) is an autosomal dominant disorder, which involves calcium dysregulation in skeletal muscle cells. It´s characterized by a life-threatening hypermetabolic state that develops following patient exposure to triggers such as volatile anesthetic agents and depolarizing neuromuscular blockers. The main clinical features of MH are: hypercarbia, tachycardia, hyperthermia, acidosis, muscle rigidity and rhabdomyolysis.Methods: An otherwise healthy, 33-year-old pregnant women with no previous anesthetic history of general anesthesia (GA) was scheduled for labor induction at 41 weeks of gestation, which failed, thus requiring cesarean delivery. However, the patient had family history (firstdegree cousin) of MH during GA. We decided to perform spinal anesthesia (L3-L4 level, 27G Quincke® needle, administered 8 mg of hyperbaric bupivacaine 0.5% plus 2 mcg sufentanyl, achieving surgical anesthesia up to T6 level bilaterally). Due to the potential risk of MH, precautions were taken to avoid all possible triggers in the event of a block failure such as:Results: A satisfactory spinal block was achieved, which allowed surgery without complications. Throughout the entire procedure, the patient remained complaint-free and hemodynamically stable without evidence of MH. Conclusion:Patients susceptible to MH may be submitted to GA if triggers are avoided, but the procedure is not risk-free. While several strategies for MH-prevention under GA exist, regional anesthesia proves to be the technique of choice, not only for its well-known advantages in obstetric surgery, but also because local anesthetics are considered safe in this setting, allowing an uneventful anesthesia with no exposure to MH-triggering agents.